Headaches are common and are often just a nuisance. When headaches become chronic or severe, however, they can be debilitating. Several types of headaches, such as migraines, can become chronic. Recognizing the differences between migraines and other types of headaches will make diagnosis, treatment and prevention easier.
Characteristics
Migraines have distinct features that differentiate them from other types of headaches. They're characterized by severe, throbbing pain usually on one side of the head and typically last from three to 72 hours. They may be preceded by an aura, comprising visual disturbances such as halos or flashing lights, and tingling in the hands or face and a metallic taste in the mouth. Migraines are also accompanied by nausea, vomiting and sensitivity to light or sound. By comparison, tension headaches produce a dull pain, mild to moderate in intensity. The pain occurs on both sides of the head or forehead and is accompanied by tightness in the back of the head and neck. Cluster headaches cause intense pain behind one eye but last only 30 minutes to three hours. Cluster headaches are accompanied by sinus drainage, eye redness or a drooping eyelid on the affected side. The headaches occur up to six times a day over the course of several weeks or months.
Causes
Each type of headache has different causes. Migraine causes are different for each person. Common migraine triggers include foods (for example, hard cheeses, wine, chocolate or processed foods), lack of sleep, weather changes, fluctuating hormone levels or waiting too long to eat. Tension headaches may be caused by stress, anxiety, holding one position for too long, depression or poor posture. The cause of cluster headaches is unknown, although the headaches may be related to changes in levels of the hormones cortisol or melatonin or the neurotransmitter serotonin.
Treatment
Nonsteroidal anti-inflammatory medications (NSAIDs) may be used to treat migraines, tension headaches and cluster headaches. NSAIDs include aspirin, acetaminophen, ibuprofen and naproxen in over-the-counter or prescription strength. A class of drugs called triptans effectively treats migraines and may also be used for tension headaches if the person also has migraines. Triptans include sumatriptan, zolmitriptan and rizatriptan. Cluster headaches respond to pure oxygen. Injected or inhaled triptans, dihydroergotamine and octreotide may also be effective. Local anesthetics or surgery may be used for people who fail to respond to other treatments.
Prevention
Migraines and tension headaches may be prevented by keeping a detailed headache diary and avoiding foods or situations that trigger the headache. Relaxation exercises help prevent tension headaches. Low-dose amitriptyline is used as a preventive treatment for people who have frequent migraines. The first episode of cluster headaches cannot be prevented, but once the cycle starts, prevention therapy may include corticosteroids, ergotamine or nerve blocks.
When to See a Doctor
Consult a doctor if you have more than three headaches a week, you take analgesics for your headache almost every day, the recommended dose of an over-the-counter analgesic does not relieve the headache or the pattern or severity of the headaches changes. Seek immediate care if you experience the worst headache you have ever had, if the headache is sudden or accompanied by fever, stiff neck, confusion or double vision, if the headache is the result of a head injury or if the headache worsens after rest and analgesics.
Tags: tension headaches, types headaches, become chronic, Cluster headaches, cluster headaches, other types